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Outcome of systemic therapy in patients with advanced rare skin cancers: a retrospective multicenter DeCOG study of 209 patients

  • Introduction For rare skin cancers, few data exist on the outcome of systemic therapies, particularly immune checkpoint inhibition (ICI). The present study analysed the real-world use of different systemic therapies including ICI, and its outcome in patients with advanced rare skin cancers. Methods This retrospective multicenter study included patients who received systemic therapy for advanced, non-resectable cutaneous angiosarcoma (AS), Kaposi sarcoma (KS), pleomorphic dermal sarcoma (PDS), or cutaneous adnexal carcinoma (CAC). Study endpoints were best overall response (BOR), progression-free survival (PFS) and overall survival (OS). Results 209 patients (77 AS; 81 KS; 14 PDS; and 37 CAC) from 30 centers were included. As first-line treatment AS and KS patients predominantly received chemotherapy (77.9 %; 63.0 %), while PDS and CAC patients mostly received ICI (64.4 %; 43.2 %). BOR in first-line across all therapy types was 65.5 % in KS, 50.0 % in PDS, 41.6 % in AS, and 10.8 %Introduction For rare skin cancers, few data exist on the outcome of systemic therapies, particularly immune checkpoint inhibition (ICI). The present study analysed the real-world use of different systemic therapies including ICI, and its outcome in patients with advanced rare skin cancers. Methods This retrospective multicenter study included patients who received systemic therapy for advanced, non-resectable cutaneous angiosarcoma (AS), Kaposi sarcoma (KS), pleomorphic dermal sarcoma (PDS), or cutaneous adnexal carcinoma (CAC). Study endpoints were best overall response (BOR), progression-free survival (PFS) and overall survival (OS). Results 209 patients (77 AS; 81 KS; 14 PDS; and 37 CAC) from 30 centers were included. As first-line treatment AS and KS patients predominantly received chemotherapy (77.9 %; 63.0 %), while PDS and CAC patients mostly received ICI (64.4 %; 43.2 %). BOR in first-line across all therapy types was 65.5 % in KS, 50.0 % in PDS, 41.6 % in AS, and 10.8 % in CAC. BOR for ICI was 66.6 % for PDS, 58.3 % for AS, 33.3 % for KS, and 4.3 % for CAC, irrespective of treatment line. 1-year PFS rate upon any first-line therapy was 70.7 % for PDS, 45.7 % for KS, 25.6 % for AS, and 18.5 % for CAC (p < 0.001). 1-year tumor-specific OS rate was 97.3 % in KS, 84.2 % in AS, 67.7 % in PDS, and 65.4 % in CAC (p < 0.001). Conclusions Type and outcome of systemic therapy differed between cancer entities. Efficacy of ICI was high in PDS and AS, moderate in KS, and low in CAC. Patients with advanced CAC revealed an extremely poor prognosis regardless of the type of therapy used.show moreshow less

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Author:Selma Ugurel, Nessr Abu Rached, Thilo Gambichler, Miriam Mengoni, Thomas Tüting, Jessica C. Hassel, Robin Reschke, Georg C. Lodde, Jan-Malte Placke, Dirk Schadendorf, Lydia Reinhardt, Alexander Kreuter, Martin Gschnell, Jochen Utikal, Michael Erdmann, Pia Dücker, Doris Helbig, Cindy Franklin, Christoffer Gebhardt, Gabriela Poch, Katharina C. Kähler, Michael Weichenthal, Ralf Gutzmer, Lucie Heinzerling, Carsten Weishaupt, Peter Mohr, Kai-Martin Thoms, Berenice Lang, Bastian Schilling, Sebastian Haferkamp, Michael Sachse, Julia WelzelORCiDGND, Franziska Jochims, Ulrike Raap, Gaston Schley, Patrick Terheyden, Edgar Dippel, Christoph Pöttgen, Jürgen C. Becker, Alpaslan Tasdogan, Teresa Amaral, Lena Nanz, Ulrike Leiter
URN:urn:nbn:de:bvb:384-opus4-1250032
Frontdoor URLhttps://opus.bibliothek.uni-augsburg.de/opus4/125003
ISSN:0959-8049OPAC
Parent Title (English):European Journal of Cancer
Publisher:Elsevier BV
Type:Article
Language:English
Year of first Publication:2025
Publishing Institution:Universität Augsburg
Release Date:2025/09/10
Volume:228
First Page:115750
DOI:https://doi.org/10.1016/j.ejca.2025.115750
Institutes:Medizinische Fakultät
Medizinische Fakultät / Universitätsklinikum
Medizinische Fakultät / Lehrstuhl für Dermatologie
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):CC-BY 4.0: Creative Commons: Namensnennung (mit Print on Demand)